Provider Demographics
NPI:1902050750
Name:SCHELLINCK, AUSTIN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:
Last Name:SCHELLINCK
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 SANTA RITA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-5666
Mailing Address - Country:US
Mailing Address - Phone:925-398-8903
Mailing Address - Fax:925-401-7013
Practice Address - Street 1:1400 SANTA RITA RD
Practice Address - Street 2:SUITE B
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-5666
Practice Address - Country:US
Practice Address - Phone:925-398-8903
Practice Address - Fax:925-401-7013
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA582131223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics